The Birth of Isla Michelle

Better late (i.e. nearly 5 months later...) than never, right?  I'll be honest, the last five months have been a whirlwind.  I worked through most of my maternity leave, then returned to work full-time at 10 weeks post-partum, Bennett was hospitalized for a week in April, and well...life with three kids is just plain HECTIC.  So, forgive me.  But I have to share this story.  I think it is even more poignant to me now than it was in the immediate aftermath.  I've made no secret that my first two births scarred me - literally and emotionally.  I wanted so badly to have a healthy, HAPPY birth with Isla, and I accomplished that.  This baby girl has healed me in so many ways.

Its a loooong story (yes, feel free to pity me), so hang in there.  On to the narrative:

Thursday, December 23

I went to the OB and was really feeling discouraged. The week before, I was told I was 2.5 and 80%. This OB said I was much more like a 2 with a lot of length still. WTF? That's like NO progress since 30 weeks!!! She asked me if I wanted my membranes stripped. I said, if she thinks it will help, sure, but if not, then let's wait because it would be much more effective the following week. She said she wouldn't do an "aggressive" strip, just see if she could help loosen it up some. She really doubted it would start my labor though, and said to tell the OB I saw next week to strip me "really good." With vbacs, there is much more concern about going overdue as the success rates are shown to decrease significantly at that point, and obviously there are very limited options for induction. She didn't think it was a big deal, but she said she didn't want another doc freaking out on me for going post dates. So, I left the appointment really frustrated.

So, I go home feeling conflicted - glad that I would not likely have the baby in the middle of the holiday, but just ready to be done and afraid of having to deal with going over due. That afternoon, I started to get REALLY crampy. Not contractions per se, but yucky menstrual like cramping.


Friday, December 24

When I woke up on Christmas Eve morning, I started to feel like something was brewing. The cramps were growing more intense. I spent the day cleaning and organizing. My parents arrived from Kentucky. We get ready to go the 4:00 mass. Right before the mass, I start having super painful contractions with the cramps. They aren't super close, but they are getting really "deep" and intense. The entire night, the contractions start to grow closer bit by bit and more painful. We had our celebration with Ace's family that night and everyone kept telling me I was going into labor - I just had that "look." Around 11:30 pm, I try to go bed. I couldn't lie in bed to save my life. I was having contractions every 5-6 mins and I couldn't stand to lie down through them. I was like "great...of course she's going to come NOW, and I'll miss Christmas morning with my kids!" So, I "slept" in the glider in the nursery all night in between the contractions and tried to focus on relaxing and trying to keep the contractions from getting closer.

Saturday, December 25
Christmas morning, I decided to wake the kids up at 7 a.m. to open presents b/c the contractions are 5-6 min apart at this point and requiring concentration to get through them. We had a nice Christmas morning, and I was so glad she held off. The entire day, my contractions ranged from 5-8 min apart at various points.  My mom helped keep me distracted by playing Gin-Rummy and making me walk on the treadmill - ha!  It was starting to get really exhausting, especially since I really hadn't slept more than a few minute snipits the night before. I was contemplating calling my doctor to see if something was "wrong" that could be keeping me from going into active labor, or if I could take something to help me at least sleep. Then, around 9 p.m., my contractions almost completely STOPPED. I was about to lose my mind at this point. I just started crying. I lied down to try to sleep. I was still contracting, but every 15 minutes. BUT, the contractions were more intense than anything I had ever had up to this point. I couldn't stay in bed through them. I posted on Facebook about my frustration. Everyone suggested getting in the shower. Honestly, that was the LAST thing I felt like doing at the moment. I just didn't feel like getting wet. I just wanted to SLEEP!!!

But, I figured what the hell, and got in the shower. Wow. Almost immediately, my contractions picked up to every 3-5 minutes apart. I yelled to Ace to come in the bathroom to time them. It was funny actually because he was playing Starcraft and was super annoyed that I was interrupting him. But after he saw a few come super close, he decided it was time to log off. After this lasted 30 mins, I called my OB and told him what was up. Since I had a far drive and there was a forecast for bad weather, he told me to come in and they'd see if it was real. I honestly fully expected the contractions to stop again. But no. Every 5 minutes like clock work the entire drive there!!! I wanted to kill Ace, as it seemed like he was taking every curve extra tight and hitting every pot hole along the way!

Sunday, December 26

My last belly pic - Still able to smile!

We got there at 12:05 a.m. I thanked Isla for NOT having a Christmas birthdate.  There was only 1 other mom in labor at the time. I go into triage, and I fully expected her to tell me that I'm a 2. Nope. She said I'm a 4.5 conservatively, but probably more like a 5 and almost completely effaced. Baby was still high at -1 though. They get me checked in to my L&D room. My nurse comes in and I immediately do not like her. She is Chinese and hard to understand, and just brash. She asked me if I had a birth plan, and I gave it to her. She said "most moms who say they don't want an epidural end up getting it, and right now is the ideal time if you are going to get it." I said no thanks. Then I hear her talking to my OB in the hall say "Another one who thinks she's going natural." B!t(#. So, I didn't like her the rest of the night.

My doc checked me and said I was a good 6 and 100%. I was feeling SO confident at this point. I was handling the contractions pretty well. I felt like I really could do this. I knew transition was going to hit soon and was mentally preparing myself. Sure enough, within an hour, the contractions were about 2 minutes apart, and it seemed like they would come two at a time before I'd get a break. So, the nurse sees this on the monitor and comes in and checks me and I'm 7 cm. I was SO psyched!! I felt like I was handling it really well. I knew that this meant my baby was really close, as transition generally lasts 1-2 hours, right? Well, after an hour of this, the nurse checks me again and I'm STILL a 7. I was disappointed, frustrated, but determined not to let it get me down. No big deal... But over the next hour, I was starting to really struggle with it. I'd been in transition about 3 hours at this point! They check me again and I'm STILL 7. I started to lose it. I could take it 1 contraction at a time, I knew that. But I mentally couldn't handle the thought of HOURS more of this.

I asked the nurse if I could get an IV narcotic to help calm me down because I was starting to get panicky feeling. Nope, she said it was too late. My only option was an epidural. I said no, I don't want it. But I was really starting to doubt my self at this point. Each contraction that came after that, I started to lose control more and more. I started to hyperventilate and tremble and felt literally like I as spinning out of control. My mom did an excellent job of helping me to refocus, but every time I'd panic, Isla's heart rate would go super low then super high. The nurse came in and said I really needed to focus on BREATHING b/c the baby wasn't liking it. I tried my darndest, I really did, but every few contractions, I'd lose it again and go into an anxiety attack. Finally, I said F it. Give me the epidural. I can't do this. I really couldn't.

As soon as my moms left the room, I spiraled out of control. I turned into one of those crazy shrieking women you make fun of on TV. It was nuts. But I got the epidural and was able to at least calm down. The epidural was no walk in the park though. It gave me major shakes and I still felt the contractions enough to have to really work to concentrate through them. My OB came in to check me and I'm STILL 7 cm. I was so glad at that point that I got the epidural. She recommended breaking my water, as she thought that was preventing the baby from descending and stalling my dilation. Ok.

As soon as she broke my water, Isla's HR went way low. They tried positioning me a million different ways, but the only way she would tolerate it was flat on my back. Again, I was REALLY glad I got the epi at this point because there was NO way I would have been able to lie flat on my back through this, and I'd have been off to a c-section for sure. I didn't get the rest I'd hope for with the epi though because I was panicking at every decel she had and was shaking like a leaf. I also had a "window" in my left hip where the epi didn't work at all, and I had the most intense stabbing pain there with each contraction. I had one mom putting her weight on my shoulders to help stop the shaking and the other one pushing my hip in!  Thank God for them!

I cannot tell you the sheer RELIEF I felt when the nurse told me I was complete!! I was so scared for Isla at this point and just wanted her OUT safely. Her HR was in the 100-120 range the last few hours. She had me do a few practice pushes, telling me to push into my butt. Only problem was, I couldn't FEEL my butt!  I asked her to turn the epi off or at least down, but she wouldn't. I never got the urge to push. That made it really difficult. Fortunately, because of the window in my hip, I could feel when a contraction came, but otherwise, I felt like I was pushing blind. My OB came in and helped me out tremendously. She pressed on my perineum so I had a focal point to push toward. Unfortunately, because of the HR issues, I had no choice but to push flat on my back, which felt SO unnatural. But I guess it wasn't too bad because it only took me 25 minutes to push her out!!! Once her head started to emerge, I felt the ring of fire, and that was all the motivation I needed to get her OUT!

It had been my wish to let the cord stop pulsing before cutting, but I knew something was up when she made me stop so she could cut the cord before delivering the rest of her. It only took one push after that, and they put her on my chest. It was the most incredible feeling ever. I just held on to her so tight. She as soo warm!! I just started bawling. I can't even put into words what I felt at this moment!! It was a confluence of a sense of awe of what had just happened, this little creature, everything!

Awestruck!

Unfortunately, she wasn't breathing, so they had to take her to the warmer pretty quickly. They got her breathing there but she was breathing really fast and having retractions, which meant she was having to work too hard to breathe. And her heart rate was very irregular. They started her on oxygen and called the NICU. The Neonatologist came in pretty quickly and looked her over. He explained to me what happens sometimes when a baby has a tight nuchal cord in utero, it can cause acid to build up in their blood stream. This caused her to have respiratory distress at birth. So, they took her to the NICU to give her some IV meds to help flush out the acid and kept her on O2 for a while until she was able to breath well on her own. I was obviously pretty upset by this all. How ironic - I get a termie and she still goes to the NICU! The nurse told the Neo about Bennett so the Neo said they could do her weight and measurements in the room with me and let me hold her for a few minutes before transferring to the NICU. I really really appreciate that!!!

She was 7 lbs 6 oz and 20 1/4'' long.  Her AGARS were 5/6/8.

Needing a little extra oxygen

Daddy talking to his girl!

The epidural wore off pretty quickly, but my right leg stayed totally numb for several hours.  So, they wheeled me to the post-partum room and told me to sleep.  After being awake for the past 50+ hours, 41 hours of which were spent in labor, they didn't have to tell me twice.  I was OUT and slept the deepest sleep I think I've ever had in my entire life.  When I woke up, I hopped out of bed and declared I was ready to go see my baby!  I walked down to the NICU (which AMAZED me because I didn't walk for at least 24 hours after the boys were born) and found my baby girl sleeping soundly in a warmer, with the blood and amniotic contents still matted in her hair even!  She was doing GREAT so they let me nurse her and she took to it immediately like an old pro.  Then we gave her a MUCH needed bath.  I felt like I was high on happy juice the whole time!

Chillin' in the NICU

By 6 pm they let her come over to the post partum ward with me and has been FINE ever since. She's a beautiful girl and pretty easy. But according to Carter, she has "big attitude" when she's upset, lol. I ADORE her.

Big Brothers meeting their Lil Sis!

She is my little girl - something that has taken on a meaning I could have never imagined.  She is perfect in everyway.  I thank God for her.  Beyond just being amazing in her own right - she has literally healed me from the traumas I carried from Carter and Bennett's births.  It was not a perfect birth.  I was a little disappointed that I didn't go 100% natural.  But I went full term.  And I got to hold her on my chest when she was born.  And she is perfectly healthy.  So, in the end, it was MY perfect, imperfect birth. 

Going Under the Knife

I bet you didn't know that April is in fact Cesarean Awareness Month, now did you?? Well, it is. So, I'm going to take this opportunity to shed a little more light on what - in my humble opinion - is a deplorable increase in cesarean births in the United States. Approximately 1/3 of all babies born today in this country are born via cesarean. And that number continues to grow.

I've had two cesareans, and to be quite frank, I'm rather pissed about it. Neither of my birth experiences came even remotely close to what I had wanted or dreamed of for so long.

I was a month shy of 24 when I gave birth to Carter. I was still rather young and meek and submissive, particularly to doctors, at that point. I thought, surely, if a doctor says you should do something, that means you really should, right? So, when my obstetrician told me she thought I should be induced two weeks before my due date because baby boy has a big noggin, and since a definitive end date was sounding pretty good at that point...I readily agreed to it. My doctor failed, however, to give me some pretty important details. Namely, that over 50% of first time mothers who are induced end up with a cesarean. And that induction in the vast majority of cases leads to other interventions that could otherwise be avoided. Nope, not a bit of that was mentioned.

So, I went to the hospital at 6 a.m. on March 11th, thinking they would just break my water (as we had agreed) and see what happened since I was already 2.5 cm dilated and almost completely effaced (meaning my body was on the brink of going into labor on its own anyway for those who don't know labor-speak). Rather than breaking my water, they hooked me up to a IV with pitocin - a.k.a the Devil's Spit. I should have protested, but I didn't. I was nervous and scared and really just wanted to have this baby already! The contractions came on hard and fast. An hour into it, my doctor showed up (how nice of her) and broke my water. HOLY MOLY OUCH. My pain level instantly tripled. Turns out, Master Carter was occiput posterior - facing up rather than down like he should be. And that my dear friends made the hardest part of his head press into my spine with every contraction - back labor. I had these delusions that I would have a med-free natural birth, but after 12 or 13 hours (who's counting at that point...) of laboring on pitocin with no pain meds, and without making much progress, my doctor gave me the option of an epidural or a cesarean. That was an easy choice. So I got the damn epi, and it worked for a whopping hour then wore off, but not before making me vomit and shake uncontrollably. Like you need MORE discomfort on top of discomfort. But I did in fact finish dilating. So, I started to push, and I got him down to the point where we could see his little head starting to come through, but every time I would push, his heartrate would drop. So, they had me wait and see if my body would bring him down naturally. Nope. I tried pushing again, and his heartrate kept plummeting to scary lows. So my doctor said (with sleep lines all over her face because it was after all 3 a.m.) I'm off to a c-section. NO!!!!!!!!!!!! This is not how it was supposed to happen!!! This was my nightmare!

So, Carter was born via cesarean. They cut me open, took out my baby, then took him to a warmer to clean him off, look him over and bundle him up. I got to lay eyes on my firstborn child for the first time as they were wheeling me out of the operating room and into the recovery room. I tried to hold him, but my arms couldn't support him from being numbed from the anesthesia. Within an hour after the delivery, I got very ill and they had to take him away because I was useless to him at the moment. I got to see him again 5 hours later. This is definitely NOT what I had envisioned giving birth to be like.

But my doctor assured me that I could try for a vbac (vaginal birth after cesarean) for my second child. So, I held onto that, made peace with my cesarean, and looked forward to giving birth the "right" way one day.

When I got pregnant with Bennett, I did all the right things to prepare for my vbac. I did all the research and was lining up interviews with doulas (special birth partners). Then, my water broke at 24 weeks. And of course, Bennett was breech. So there went my hope for a vaginal delivery. This time, my cesarean was even worse. I had uncontrolled bleeding during the surgery and it took them a good while and a lot of force to get the bleeding to stop. My recovery was extremely long and painful. Nearly a year later, I still have pain on one side of my incision where they nicked a muscle closing me up. Definitely not the birth I had envisioned.

So, I can hold on to hope for a vba2c, right??? Probably not. I will be lucky to find a doctor in Maryland who will attend a vbac after 2 cesareans. I'll save the argument for why THAT sucks for another day, as the risks of having something go wrong is still very slim. But the point remains, my dreams of giving birth to my child, of having them lay him on my chest while Ace and I stare down at him, of having those crucial bonding moments together - those dreams have been sliced to pieces with a very sharp scalpel.

Now, I realize that not all women feel so strongly againt cesareans. And not all women have bad experiences with them. But the facts are clear that cesareans generally are not a good thing, and should be avoided a much as possible.

* It is MAJOR abdominal surgery with huge risks to the mother of infection, blood loss and hemorrhage, hysterectomy, transfusions, bladder and bowel injury, incisional endometriosis, heart and lung complications, blood clots in the legs, anesthesia complications, and rehospitalization due to surgical complications, rate of establishment and ongoing breastfeeding is reduced, and psychological well-being compromised and increased rate emotional trauma. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sex. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions.

* Half of all women who have a cesarean encounter some complication from it. The death rate from cesarean is between 2 to 4 times greater than that from vaginal births. 180 women in the U.S. die from elective repeat cesareans every year.

* Each successive cesarean greatly increases the risk of developing placenta previa, placenta accreta and placental abruption in subsequent pregnancies. Both of these complications pose life-threatening risks to mother and baby. Cesareans also increase the odds of secondary infertility, miscarriage and ectopic pregnancy in subsequent pregnancies.

* There are risks to the baby too - respiratory distress syndrome (RDS), prematurity (when surgery is performed because of an error in determining the due date), persistent pulmonary hypertension (PPH), and surgery-related fetal injuries such as lacerations. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at risk babies born by cesarean fare worse than those born vaginally. Just today, I read a study that showed that being born via cesarean increases a child's odds of developing asthma by 80%!!!!!

* Cesareans can delay the opportunity for early mother-newborn interaction, breastfeeding, and the establishment of family bonds.

Unfortunately, it seems that the common-place occurrence of cesareans in this country has distracted us from the stark reality that it is a dangerous procedure for both mother and child. There are numerous reasons why the cesarean rate continues to rise, and I will definitely do a blog on that another day (in the meantime, you should try to watch Ricki Lake's documentary called "The Business of Being Born" - its fascinating!!). Suffice to say that something needs to be done. This is unacceptable and unnecessary. According to the World Health Organization, only approximately 10-15% of deliveries should be cesareans. As the nurses used to "joke" with me while I was on bedrest - it seems that the doctors all got a shiny new scalpel to try out.

(Disclaimer - I am fully aware that not all, and probably very few, doctors perform cesareans for any reason less than full belief that it is medically necessary, and yes, there are situations in which a cesarean is medically indicated).